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Cottin Y, Ben Messaoud B, Yao H, Laurent G, Bisson A, Eicher J, Bodin A, Herbert J, Juilliere Y, Zeller M, Fauchier L. Exploring the temporal relationship between atrial fibrillation and heart failure development. Analysis from nationwide database. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) and heart failure (HF) often coexist and are closely intertwined, each condition worsening the other. The temporal relationships between these two disorders have not yet been fully explored. We assessed, on a nationwide scale, the prognosis of patients hospitalized with HF and AF, based on the timing of AF and HF development.
Methods
From the administrative database covering hospital care for the whole French population, we identified 1,349,638 patients diagnosed with both AF and HF between 2010 and 2018: 956,086 of these AF patients developed HF first (prevalent HF) and 393,552 developed HF after AF (incident HF). The outcome analysis (all-cause death, cardiovascular [CV] death, ischemic stroke or hospitalization for HF) was performed with follow-up starting at the time of last event between AF or HF in the whole cohort and in 427,848 propensity-score-matched patients (213,924 with incident HF and 213,924 with prevalent HF).
Results
During follow-up (mean follow-up 1.6±1.9 year), matched patients with prevalent HF had a higher risk of all-cause death (21.6 vs 19.2%/year), CV death (7.6 vs 6.5%/year) as well as non-cardiovascular death (13.9 vs 12.7%/year) than those with incident HF. The risk for ischemic stroke was lower in the prevalent HF group (1.2 vs 2.4%/year).
Conclusion
In patients hospitalized with both AF and HF, we identified two distinct clinical entities based on the chronological sequence of the two disorders. Patients in whom HF preceded AF (prevalent HF) had higher mortality and higher risk of rehospitalization for HF.
Funding Acknowledgement
Type of funding sources: None.
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Cottin Y, Issa R, Benalia M, Mouhat B, Meloux A, Tribouillard L, Bichat F, Vergely C, Zeller M. Association between serum osteoprotegerin levels and severity of coronary artery disease in patients with acute myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Osteoprotegerin (OPG), a glycoprotein of the tumor necrosis factor (TNF) superfamily is a main biomarker for vascular calcification.
Aim
We aimed to evaluate the association between serum OPG levels and extent of coronary lesions in patients with acute myocardial infarction (MI).
Methods
Consecutive patients hospitalized for an acute MI who underwent coronary angiography were included. SYNTAX score was calculated to assess the severity of coronary artery disease. The population was analysed in low (5 (3–6)), medium (11 (9–13)) and high (20 (18–23)) tertiles of SYNTAX score.
Results
Among the 378 patients included, there was a gradual increase in age, rate of diabetes, anterior wall location, and a reduction in left ventricular ejection fraction across the SYNTAX tertiles. OPG levels significantly increased across the tertiles (962 (782–1,497), 1,240 (870–1,707), and 1464 (1,011–2,129) pg/ml, respectively (p<0.001)). In multivariate analysis, OPG [OR (CI95%): 2.09 (1.31–3.32) p=0. 002], were associated with the high SYNTAX group, beyond hypercholesterolemia, CV history and creatinine.
Conclusion
We found an association between OPG levels and coronary lesions complexity patients with acute MI. Determining OPG levels in combination with an ischemia test could be used in the clinical setting for the early diagnosis of subclinical atherosclerosis.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): CHU Dijon BourgogneConseil Régional Bourgogne Franche Comté
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Chague F, Cottin Y, Lhuillier I, Guinchard S, Tribouillard L, Bichat F, Maza M, Saint Jalmes M, Massenot J, Laurent G, Zeller M. Sport-related acute myocardial infarction. Contemporary data from IMACS survey. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sport-related (SR) acute cardiovascular (CV) events are the main cause of sudden cardiac death in the setting of sport activities. However, data are very scarce regarding onset and follow-up of SR acute myocardial infarction (AMI).
Methods
From the prospective study IMACS (Infarctus du Myocarde et Arret Cardiaque au cours du Sport) patients admitted for a SR-AMI in our university hospital from April 2018 to March 2020 were included. A 12 months follow-up (FU) was achieved through telephone interview to address CV outcomes and sport practice information. Information was obtained from relatives in case of out of hospital sudden cardiac arrest (OH-SCA).
Results
Among the 55 patients included, all were male, with median (IQR) age at 62 (55–69) y. Most common sports were cycling (n=21), fitness (n=7), swimming (n=5) and hiking (n=5). The SR-AMI occurred during effort for 39 subjects and during recovery for 16. Most SR-AMI occurred in public area (n=24), at home (n=16), or in a specific sport location (n=14). An Automated External Defibrillator (AED) was available in the SR-AMI location in only 10, but was missing in 43 (unknown for 2). In 1 subject with OH-SCA, cardiopulmonary resuscitation (CPR), initiated by witnesses, using a public AED, was unsuccessful. The 4 other patients with OH-SCA underwent successful CPR. Among the 55 subjects, 4 were vapers, of whom 1 was a dual user, 17 were current tobacco smokers, 18 were ex-smokers and 2 experienced cannabis and cocaine use. Among the smokers, most smoked (n=10) or consumed cannabis (n=1) <2h before the event. Strikingly, CV history and/or recent symptoms were present in almost half (n=25). Only 10 felt symptoms exclusively during the sport session. Moreover, a medical advice for recent symptoms was found only for 3 subjects. Three patients who experienced prior AMI have neglected symptoms during the index event. Most were ST segment elevated MI (n=35). Only one patient (with OH-SCA) died <3 days after hospital admission. During hospitalization, most underwent revascularization with coronary stenting (n=44) (drug eluting stent in 43 patients), or coronary artery bypass graft (n=6) and no death nor significant CV event occurred. At 1-FU, most attended a rehabilitation program (n=41) and the majority of smokers quitted (14/17), with 3 persistent smokers starting to vape. Almost half patients (n=23) decreased their physical activity, and 21 increased it. A significant rate of patient (n=9) added fitness in their usual activity, and as a main sport for 4 of them.
Conclusions
In this on-going monocentric prospective survey in SR-AMI, a high proportion of subjects had prodromal symptoms, of whom only few led to sport cessation and medical advices, when requested, failed to prevent the AMI. Our findings highlight that public and medical education are urgently warranted for SR-AMI prevention.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): CHU Dijon Bourgogne Franche Comté et ARS Bourgogne Franche Comté
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Cottin Y, Boulin M, Doisy C, Mounier M, Caillot D, Chretien ML, Bodin A, Herbert J, Bonnotte B, Zeller M, Maynadie M, Fauchier L. New onset atrial fibrillation and heart failure among patients with multiple myeloma: analysis from a nationwide french medical information database. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Over the last decade, new therapies, screening optimization, and cardiovascular management have changed the cardiovascular prognosis of patients with multiple myeloma (MM). Older studies suggested that MM could be associated with increased risk of heart failure (HF). Based on a nationwide hospitalization database, we aimed to assess the risk of hospitalization for Heart failure (HF) and/or Atrial fibrillation (AF).
Methods
From 1st January 2013 to 31st December 2013, 3,381,472 adults (age ≥18 years) were hospitalized for any reason in French hospitals and then had at least 5 years of complete follow-up (or suffered death earlier). We identified 15,774 patients diagnosed with known MM at baseline. The outcome analysis on hospitalization for new onset HF or AF was performed with follow-up (FU) starting at the time of last event. For each patient with MM, a propensity score-matched patient with no MM was selected (1:1) using the one-to-one nearest neighbor method (n=15774 in each group).
Findings
In the propensity-score-matched population, mean±SD FU was 3.7±2.3 years, median (IQR)5.0 (1.3–5.7) years, mean age was 71±12y, and most were female (55%). When compared with patients without MM, MM patients were more likely to have history of HF (16.8% vs. 10.5%, p<0.0001), pulmonary edema (1.5 vs. 0.8%, p<0.0001), or AF (13.4% vs. 9.6%, p<0.0001). At FU, MM patients had a higher risk of all-death (yearly rate 20.02 vs 11.39%/year). Moreover, yearly rates of new onset HF or AF, which were the common CV causes of re-hospitalisation, were higher in the MM group, i.e. respectively for incidence rate, 7.47 vs 5.42%/year (p<0.0001) and 4.57 vs 3.72%/year (p<0.0001). Multivariate analysis showed that MM remained significantly associated with a higher rate of HF and AF (HR (95% CI): 1.343 (1.276–1.413) and 1.196 (1.128–1.269), respectively). Results were similar in sensitivity analysis limited to patients with recent MM (i.e. diagnosed within the 3 previous months).
Interpretation
From a large nationwide hospitalization database, we show that patients with MM had a higher risk of new onset HF and AF. Our findings highlight the key issue of cardiovascular management in patients with MM.
Funding Acknowledgement
Type of funding sources: None.
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Chague F, Israel J, Guinoiseau JP, Garet G, Reboursiere E, Ngassa P, Hager JP, Geneste M, Sarda J, Dincher JC, Cottin Y, Zeller M. Tobacco-related risk behaviors among amateur rugby players, coaches and referees: targets for prevention. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
High prevalence of smoking has been documented in France and new patterns of tobacco and nicotine consumption are emerging, especially in some sports. In amateur rugby population, such attitudes could be harmful, but data are scarce as well as their knowledge of the risk.
Purpose
We analyzed tobacco consumption in French amateur players, coaches and referees.
Methods
Each amateur players [>12-y/o], coaches and referees licensed in the French Rugby Federation and participating in the Burgundy amateur championship was invited to answer to an electronic anonymous questionnaire during the 2017–2018 sport season.
Results
683 [sex ratio M/F = 0.9] answers were obtained and fit for analysis. Among them, 559 (81.8%) were players, 167 (24,5%) were coaches and 74 (10.8%) were referees. 176 subjects (25.8%) were current smokers, 126 (18.4%) daily smokers, 54 (37% of usual smokers) smoked more than 10 cigarettes a day and 97 (14.2%) were ex-smokers. Moreover, 24 referees (32.4%) and 47 coaches (28.2%) were current smokers. Most smoked 2 hours before or after a rugby session (86.4% of smokers), including coaches (89.4%) and referees (89%). Although 109 smokers (61.9%) considered quitting, only 27 (24.8%) considered vaping to aid them. Only 28 subjects (4.1%) usually vaped, of whom 15 daily (1.9%); 21 of them (75%) vaped in the 2 hours before or after a rugby session. Number of cigarettes in the 19 dual users was not different compared with non-vaping smokers. Among the 28 vapers, motivation to vape included lower risk than smoking (13), consider to quit (12), cheaper than smoking (8), festive and socializing (6), avoid to smoke (3), respect the performance (2). Other tobacco or nicotine products were infrequent: waterpipe (7), dry snuff (1) and none used snus. The knowledge about risk was incomplete: 35 (5.1%) subjects do not know that smoking is dangerous for their health and 12 (1.8%) think it is not. 246 (36%) and 195 (28.6%) do not know if smoking is more dangerous in the 2 hours before or after sport; 45 (6.6%) and 18 (2.6%) think it is not. Moreover, 27.5% of coaches were unaware on the risk of smoking before a sport session and 19.2% on the risk after. 244 subjects (35.7%) do not know if vaping is less dangerous than smoking; 272 (39.8%) are not informed of the potential risk of nicotine when vaping.
Conclusion
Despite information, prevalence of smoking remains high in the French amateur rugby players, coaches and referees. Smokers usually smoke in the 2 hours before or after the sport session. This is dangerous for them and for their peers. The low knowledge about the CV risk is of great concern, especially when considering the coaches and referees considering both their symbolic position and their educational role. Vaping and other patterns of nicotine exposure are infrequent; none of them use snus. Targeted education programs are urgently needed to reduce acute and chronic risk of tobacco consumption in this population.
Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): CHU Dijon Bourgogne ARS Bourgogne Franche Comté
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Zeller M, Chague F, Maza M, Bichat F, Beer JC, Masson D, Cottin Y, Farnier M. Characteristics and prognosis of patients with elevated triglycerides in acute myocardial infarction: observational data from a large database over a 17 years period. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and aim
From a large database of a regional registry, we aimed to address the prevalence, characteristics and prognosis of patients with elevated triglycerides (TG) in patients hospitalized for an acute myocardial infarction (MI).
Methods
From the multicenter database (RICO survey), all consecutive patients hospitalized for an acute MI (2001–2017) and alive at discharge were included. Patients with TG >500 mg/dL, lost to follow-up (FU), or under chronic fibrate treatment were excluded. Patients with high TG (>200 mg/dL) on admission were compared to those with TG ≤200 mg/dL. Endpoints were recurrent ischemic events (i.e. recurrent MI, angina, unstable angina, stroke or urgent revascularization (PCI or CABG)) at 1-year FU.
Results
Among the 10667 patients included, 1886 (17.7%) had elevated TG. When compared with patients with TG ≤200 mg/dL, patients with high TG were younger (59 vs 69 y, p<0.001), had a higher BMI (28 vs 26 kg/m2, p<0.001), were more frequently men (77 vs 68%, p<0.001), diabetic (27 vs 21%, p<0.001), and smokers (42 vs 28%, p<0.001). The rate of statin therapy at discharge was similar for the 2 groups (79 vs 77%, p=0.285), as well as SYNTAX score and rate of multivessel disease (p=0.368 and p=0.791). In high TG group, LDL cholesterol was higher (130 vs 120 mg/dL, p<0.001) and HDL-cholesterol was lower (37 vs 46 mg/dL). At 1-Y FU, recurrent ischemic events were more frequent in elevated TG patients (11.2 vs 9.1%, p=0.004). In multivariate logistic regression analysis, high TG (OR (95% CI): 1.356 (1.095–1.679)) remains an independent estimate for recurrent ischemic event, even after adjustment for confounding (GRACE score, diabetes, obesity).
Conclusions
In our large population-based cohort, elevated TG are common in acute MI, and associated with residual risk of recurrent ischemic events, beyond traditional prognostic markers. Our data may help to identify candidates for targeted therapies to reduce recurrent ischemic risk after MI.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Amarin
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Chague F, Carre F, Gudjoncik A, Richard C, Compagnon F, Ganancia O, Pasquereau V, Zeller M, Cottin Y. Beta-receptor desensitization after a multistage ultralong distance exercise in the desert? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although cardiac function has been largely investigated during ultra-endurance exercise, few studies addressed to multi-stage endurance race.
Methods
Serial echocardiographic assessment of cardiac function was performed in male healthy subjects during the 2014 Marathon des Sables before the race (T1), at the second (T2) and fifth (T3) arrival (236 km) then after 48h recovery. Analysis were performed by 2 sonographers blind for the results of the other and the time of measure.
Results
Among the 20 athletes, 18 completed the study (mean age 42.4, median 42). RR intervals and (Left ventricular End Diastolic Volume (Simpson) (LVEDV) changed during the race and were correlated (r2 = 0.539, p<0.001); afterload approched by Left Ventricular Meridional Wall Stress (LVMWS) did not change. LV Global Longitudinal Peak Strain (PS) and subepicardial (Epi) PS did not vary. Subendocardial (Endo) LV.PS was lower at T2 /T1, concomitant to a (non-significant) drop in LVEDV; LV strain rate (SR) was lower at T4. RR and LVEDV were higher at T3 than at T2, and higher at T4 compared to T1 and T2. As preload conditions changed during the race, we studied the response of PS and SR to the change in preload (Starling mechanism). EndoPS/LVEDV, LVPS/LVEDV and SR/LVEDV did not change during the race but were lower after recovery.
Conclusions
48h after a multistage ultralong duration exercise, we observed a drop in heart rate and contractility response to preload. The evolution of these parameters could be explained by a beta-receptors desensitization. These data need to be confirmed by other studies.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): CHU Dijon Bourgogne ARS Bourgogne Franche Comté Evolution of parameters
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Thiruvalluvar AA, Sridharan M, Rajendra Prasad KJ, Zeller M. Synthesis and crystal structure of 1-hy-droxy-8-methyl-9 H-carbazole-2-carbaldehyde. Acta Crystallogr E Crystallogr Commun 2021; 77:867-870. [PMID: 34584751 PMCID: PMC8423023 DOI: 10.1107/s2056989021007210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/13/2021] [Indexed: 11/17/2022]
Abstract
Two crystallographically independent mol-ecules are present in the asymmetric unit of the title compound, C14H11NO2, with virtually identical geometries. The carbazole units are planar. The hy-droxy group at position 1, carbaldehyde group at position 2, and methyl group at position 8 (with the exception of two H atoms) are coplanar with the attached benzene rings. The dihedral angle between the two benzene rings is 2.20 (9)° in mol-ecule A and 2.01 (9)° in mol-ecule B. The pyrrole ring makes dihedral angles of 0.82 (10) and 1.40 (10)° [0.84 (10) and 1.18 (10)° in mol-ecule B] with the (-CH3)-substituted and (-OH and -CHO) substituted benzene rings, respectively. The mol-ecular structure is stabilized by the intra-molecular O-H⋯O hydrogen bonds, while the crystal structure features N-H⋯O and C-H⋯O hydrogen bonds. A range of π-π contacts further stabilizes the crystal structure.
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Chague F, Boulin M, Eicher JC, Bichat F, Saint-Jalmes M, Cransac-Miet A, Trojak B, Soudry A, Danchin N, Laurent G, Cottin Y, Zeller M. Smoking and associated unhealthy lifestyle behaviours in patients with chronic cardiac diseases during COVID-19 related lockdown. Eur J Prev Cardiol 2021. [PMCID: PMC8136031 DOI: 10.1093/eurjpc/zwab061.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Dijon University Hospital France OnBehalf CLEO-CD Background Lockdown can affect tobacco smoking (TS) behaviours. Purpose To evaluate the impact of lockdown on (TS) and associated lifestyle behaviours in patients with Chronic coronary syndrome (CCS) and congestive heart failure (CHF) Methods CCS and CHF patients were invited to answer to a phone-call questionnaire during the 1st COVID-19 lockdown start Results (Table) 343 questionnaires were fit for analysis, 43 (12.5%) were current smokers (CS). CS were younger (p < 0.001), none stopped and 13 increased their consumption (main reasons were stress and boredom). CS felt more often cramped (p = 0.023). CS who increased their TS consumption showed a trend toward a higher rate of unhealthy lifestyle behaviours Conclusions During the lockdown, more than ¼ of CS with CCS or CHF increased their TS consumption and none quitted. Moreover, TS was often associated with other deleterious behaviours increasing their risk for short and long term Main results | Total | Non-Smokers | Smokers | p* |
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N(%) | 344 | 301 | 43 | | Age, years | 67.7 ± 12.8 | 69.2 ± 12.2 | 57.2 ± 12.1 | <0.001 | Men/Women | 229/115 | 197/104 | 32/11 | 0.300 | CCS/CHF | 220/124 | 185/116 | 36/7 | 0.004 | Urban/Rural | 163/181 | 137/164 | 26/17 | 0.073 | Living alone at home | 83(24.3) | 68(22.7) | 15(34.9) | 0.089 | COVID screening (PCR) | 11(3.2) | 7(2.3) | 4(9.3) | 0.037 | Feeling cramped | 19(5.5) | 13(4.4) | 6(14.0) | 0.023 | Feeling less well | 75(21.9) | 65(21.7) | 10(23.8) | 0.842 | K6 ≥ 5 | 81(23.7) | 70(23.5) | 11(25.6) | 0.845 | Physical activity decrease | 146(42.6) | 125(42.1) | 21(48.8) | 0.323 | Screen time increase | 154(45.0) | 130(43.5) | 24(55.8) | 0.100 | Alcohol consumption increase | 14(5.5) | 11(4.9) | 3(7.5) | 0.419 | Sleep change | 83(24.6) | 68(22.5) | 15(39.5) | 0.083 | Weight increase | 77(22.4) | 64(21.3) | 13(30.2) | 0.242 | Smokers (n = 43) | Smoking increase | No smoking increase | p** | Feeling less well | 5(38.5) | 5(17.2) | 0.238 | Screen time increase | 10(76.9) | 14(46.7) | 0.104 | Weight increase | 6(46.2) | 7(23.3) | 0.173 |
n(%) or mean ± SD. *p value: Smokers vs non smokers. **p value: Smoking increase vs no smoking increase
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Chague F, Boulin M, Eicher JC, Bichat F, Saint-Jalmes M, Cransac-Miet A, Soudry A, Danchin N, Laurent G, Cottin Y, Zeller M. Impact of lockdown in patients with congestive heart failure during the Covid-19 pandemic. Eur J Prev Cardiol 2021. [PMCID: PMC8136091 DOI: 10.1093/eurjpc/zwab061.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Dijon Football Côte d"Or OnBehalf CLEO-CD Background Congestive heart failure (CHF) can be destabilized by Covid-19 (C19) lockdown. Purpose To evaluate the impact of lockdown in CHF patients. Methods 150 out-patients from the HF Clinic of our hospital were invited to answer to a phone-call interview during the 7th week of first C19 lockdown . Results From 124 questionnaires, more than 1/5 felt worse and almost 1/4 declared a psychologic distress. CHF medications were modified in 10%. Decrease in physical activity was observed in 2/5. Almost 1/2 declared increased screen time; smokers often increased consumption. Adherence to dietary counselling was reduced by 1/6, increase in weight and HF symptoms were common. Some patients benefitted from a teleconsultation. Conclusions Our patients exhibited well-being impairment and unhealthy behaviours. Medication adherence was not diminished and the reduction in care access was counterbalanced by a switch toward telehealth. Main results | 124 patients | 75 Male (M) | 49 Female (F) | p value between M and F |
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Age, years | 71.0 ± 14.0 | 68.9 ± 13.7 | 74.3 ± 14.0 | 0.03 | Urban/Rural | 82/42 | 49/26 | 33/16 | 0.84 | HFrEF* | 87 | 62 | 25 | <0.001 | Dilated cardiomyopathy | 50 | 37 | 13 | 0.02 | Ischemic | 23 | 18 | 5 | 0.06 | Other | 51 | 20 | 31 | <0.0001 | Current NYHA class I/II/III/IV | 39/48/28/9 | 29/29/14/3 | 10/19/14/6 | 0.66 | History of NYHA III-IV class | 94 | 62 | 32 | 0.03 | Electronic device/Telemonitoring | 77/28 | 54/18 | 23/10 | <0.001/0.66 | Increase in dyspnea or edema or fatigue | 27 | 13 | 14 | 0.07 | Decrease in well-being | 27 | 12 | 15 | 0.07 | Psychological distress (#) | 23 | 15 (20.0) | 8 | 0.64 | Weight gain > 2 kg | 34 | 22 (29.3) | 12 | 0.68 | Switch for teleconsultation (##) | 16 | 11 (34.4) | 5 | 1 | Teleconsultation (total) | 23 | 14 | 9 | 1 | Decrease in physical activity | 52 | 25 (33.3) | 27 | 0.02 | Increase in screen time | 57 | 31 (41.3) | 26 | 0.27 | Increase in cigarette consumption (9 smokers) | 4 | 3 | 1 | 1 | Decrease in dietary adherence (###) | 22 (17.7) | 15 (20.0) | 7 (14.3) | 0.47 |
*HFrEF; # Kessler-6 score ≥ 5; ## from planned physical examination; ### salt, water, alcohol
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Chague F, Cransac-Miet A, Boulin M, Saint-Jalmes M, Bichat F, Soudry A, Danchin N, Zeller M, Cottin Y. During the Covid-19 lockdown, rural residence is associated to healthier lifestyle behaviours in patients with chronic coronary syndrom. Eur J Prev Cardiol 2021. [PMCID: PMC8136086 DOI: 10.1093/eurjpc/zwab061.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Dijon Football Côte d"Or OnBehalf CLEO-CD Background Lifestyle behaviours (LB) are keystones of coronary prevention and might be impacted during Covid-19 (C19) lockdown. Purpose To compare the LB in urban and rural patients suffering from chronic coronary syndrom (CCS) Methods 250 outpatients suffering from CCS were invited during the 6th week of the 1st C19 lockdown to answer to a phone-call questionnaire. Results 220 questionnaires were fit for analysis, of whom about 1/4 declared a psychologic impairment; people staying at home in urban zones trended to be more impacted. Unhealthier behaviours including cigarette smoking, decrease in physical activity and increase in screentime were common, especially in patients from urban zones. Telehealth partially counterbalanced limitation in care access and none declared discontinuation of medications. Conclusion The lockdown impacted wellbeing of CCS patients; living in rural zone was associated with a healthier LB. Main results | TOTAL | URBAN | RURAL | |
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N (%) | 220 | 107 | 113 | p * | Age (years, SD) | 66.4+/-12.0 | 64.5+/-14.0 | 68.2+/-9.5 | 0.02 | Male/Female | 154/66 | 76/31 | 78/35 | 0.77 | Alone at home | 47(21.7) | 28(26.2) | 19(17.3) | 0.13 | Feeling cramped | 16(7.6) | 13(12.5) | 3(2.8) | 0.008 | Feeling less well | 50(22.9) | 29(27.1) | 21(18.9) | 0.19 | Kessler-6 score ≥ 5 | 57(26.8) | 33(32.0) | 24(21.8)) | 0.12 | Sleep impairment | 53(24.5) | 30(28.6) | 23(20.7) | 0.20 | Angina pectorisdestabilization | 13(6.6) | 8(7.9) | 5(5.3) | 0.57 | Cancelled physical examination** | 67(63.8) | 40(65.6) | 27(61.4) | 0.68 | Switched to Telehealth*** | 16(17.0) | 7(17.5) | 9(16.7) | 1 | Coronavirus testing | 7(3.2) | 3(2.8) | 4(3.6) | 1 | Lifestyle behaviours | | | | | Cigarette smoking | 36(16.4) | 26(23.3) | 10(9.3) | 0.006 | Cigarette smoking increase | 11(30.6) | 8(40.0) | 3(18.8) | 0.27 | Decreased physical activity | 96(44.2) | 56(53.3) | 40(35.7) | 0.009 | Screentime increase | 98(45.0) | 59(55.1) | 39(35.1) | 0.004 | Alcohol intake increase | 10(5.2) | 5(5.3) | 5(5.2) | 1 | Weight increase ≥ 2 kg | 52(24.5) | 28(26.9) | 24(22.2) | 0.52 |
* between Urban and Rural **from scheduled physical examination ***from cancelled scheduled physical examination
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Farnier M, Yao C, Hounton N, Maza M, Chagué F, Bichat F, Beer J, Lagrost L, Masson D, Cottin Y, Zeller M. High levels of lipoprotein(a) are associated with the severity of coronary disease in patients with acute myocardial infarction. Data from the RICO survey. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chagué F, Hounton N, Lhuillier I, Guinchard S, Maza M, Massenot J, Bichat F, Saint-Jalmes M, Cottin Y, Zeller M. Sport-related acute myocardial infarction; Context of onset and one-year follow-up. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mertz V, Maalem Ben Messaoud B, Laurent G, Bisson A, Eicher JC, Bodin A, Herbert J, Zeller M, Cottin Y, Fauchier L. Atrial fibrillation with our with-out structural abnormalities. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pommier T, Lairet C, Leclercq T, Guenancia C, Carré M, Auvens C, Lalande A, Maza M, Zeller M, Cochet A, Bonnotte B, Cottin Y. Antinuclear antibodies in “infarct like” acute myocarditis: Change in prognosis? ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Putot A, Chagué F, Manckoundia P, Brunet D, Beer J, Cottin Y, Zeller M. Post-infectious myocardial Infarction: Does percutaneous coronary intervention improve outcomes? A propensity-score matched analysis. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chagué F, Carré F, Gudjoncik A, Richard C, Compagnon F, Ganansia O, Pasquereau V, Zeller M, Cottin Y. Beta-receptor desensitization evoked by a multistage ultralong distance exercise in the desert? ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pommier T, Leclerc T, Guenancia C, Tisserand S, Alaa El Din A, Lalande A, Lairet C, Maza M, Zeller M, Cochet A, Cottin Y. More than 50% of non-healing at one year in “infarct-like” acute myocarditis evaluated by cardiac magnetic resonance. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pommier T, Leclercq T, Guenancia C, Tisserand S, Carré M, Alaa El Din A, Lairet C, Lalande A, Maza M, Zeller M, Cochet A, Cottin Y. More than 30% of symptomatic patients at one year in “infarct like” acute myocarditis. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chagué F, Boulin M, Eicher J, Bichat F, Saint-Jalmes M, Cransac A, Trojak B, Soudry A, Danchin N, Cottin Y, Zeller M. Alarming increased rate of smoking and associated lifestyle behaviours in patients with chronic cardiac diseases during COVID-19 pandemic related lockdown. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [PMCID: PMC8719932 DOI: 10.1016/j.acvdsp.2020.10.265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Beltramo G, Cransac A, Favrolt N, Spanjaard M, Zeller M, Cottin Y, Boulin M, Bonniaud P. Impact of the COVID-19 lockdown on patients suffering from idiopathic interstitial pneumonia. Respir Med Res 2020; 79:100808. [PMID: 33422721 PMCID: PMC7833874 DOI: 10.1016/j.resmer.2020.100808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 12/02/2022]
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Praliaud R, Hélène G, Samson M, Zeller M, Boulin M, Bielefeld P, Ramon A, Cottin Y, Bonnotte B. Impact du confinement dû au COVID-19 sur la prise en charge et le contrôle de l’artérite à cellules géantes. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Greigert H, Zeller M, Putot A, Martin L, Ponnelle T, Steinmetz E, Terriat B, Arnould L, Falvo N, Muller G, Ramon A, Tarris G, Bonnotte B, Cottin Y, Samson M. Infarctus du myocarde au cours de l’artérite à cellules géantes : étude de cohorte. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Maalemben Messaoud B, Maza M, Ratheau E, Debeaumarche H, Pommier T, Zeller M, Cottin Y. Coronary artery ectasia in acute myocardial infarction: to be culprit or not to be? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Coronary artery ectasia (CAE), is only found in about 1% of acute myocardial infarction (AMI), but represents a clinical challenge in the setting of percutaneous coronary intervention (PCI), considering 1) culprit lesion or not, 2) a solely CAE or mixt 3) number, localization and size of CAE, 4) etiology and 5) therapeutic strategies. Only few studies from small cohorts have focused on infarct-related arteries. We aim to assess the impact of CAE as culprit artery on management strategy.
Methods
From 2010 to 2019, this study prospectively analyzed the characteristics, and management of 70 consecutive admitted for an AMI and with CAE at coronary angiography. Patients with ectatic infarcted-related artery (ERIA) were compared with patients without ectasia localized on infarcted-related (No ERIA).
Results
Among the 70 patients included, most had ERIA 47 (67%). ERIA patients had more frequently diabetes than patients without ERIA (32 vs 4%, p=0.01). The rate of other CV risk factors, and chronic medications, including antiplatelet agents and anticoagulants,.were similar for the 2 groups. Moreover, no difference was observed between the 2 groups for clinical parameters and biological data. Whatever the group, the ectatic artery is mainly located on the right coronary artery (RCA) (73%), of which most were ERIA (77%). ERIA group had less frequently anterior wall location STEMI (18 vs 65%, p= <0.001). The rate of diffuse coronary artery disease (91 vs 92%) and maximum CAE diameter (6.36 (6.00–7.00) mm vs 6.14 (5.53–7.64) mm, p=0.571) were similar for the 2 groups. SYNTAX was lower in ERIA patients (9.5 (2.0–18.0) vs 13.5 (7.0–23.0), p=0.031). A complete reperfusion was more frequently achieved in no ERIA group (70 vs 47%, p=0.073).
PCI data and hospital mortality are shown in Table.
Conclusion
CAE management is strongly dependent on the presence of CAE on IRA. Although rare, the optimal treatment strategy of patients with AMI and CAE remains to be elucidated. The place of intravascular ultrasound imaging needs to be investigated.
Funding Acknowledgement
Type of funding source: None
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Yao H, Farnier M, Salignon-Vernay C, Chague F, Brunel P, Maza M, Brunet D, Bichat F, Beer J, Cottin Y, Zeller M. Coronary lesion complexity in patients with familial hypercholesterolemia hospitalized for an acute myocardial infarction: data from the French RICO Survey. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although patients with familial heterozygous hypercholesterolemia (FH) are at high risk of early myocardial infarction (MI), coronary artery disease (CAD) burden of FH patients with acute MI remains to be investigated.
Methods
All consecutive patients hospitalized for an acute MI in a multicenter database (RICO) from 2012–2017 who underwent coronary angiography were considered. FH (n=86) was diagnosed using Dutch Lipid Clinic Network criteria (score ≥6). The angiographic features of FH patients were compared with patients without FH (score 0–2) (n=166), after matching for age, sex and diabetes (1:2).
Results
When compared with patients without FH, patients with FH had higher prevalence of personal and familial history of CAD (17 vs 5%, and 74 vs 5%, p=0.002 and p<0.001, respectively), and hypertension (54 vs 36%, p=0.006). Chronic statin treatment was used in only 45% of FH patients. At coronary angiography, FH had increased extent of CAD (SYNTAX score 11 (4–21) vs 8 (3–16), p=0.049) and multivessel disease (58% vs 43%, p=0.021). Significant stenosis was more frequent in left and right marginal coronary arteries. FH patients showed a trend toward more complex lesions, with less thrombus (28 vs 39%, p=0.076), but a 2 times higher rate of bifurcation lesions and calcifications (23 vs 12% and 20 vs 10%, p=0.021 and p=0.036).
Conclusions
This study addressing the coronary lesions features of FH patients with acute MI shows that FH patients had more severe CAD burden, and were characterized by complex anatomy features.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): ARS Bourgogne Franche Comté, CHU Dijon Bourgogne
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